Chest
Clinical InvestigationsFailure of Inhaled Corticosteroids to Modify Bronchoconstrictor or Bronchodilator Responsiveness in Middle-Aged Smokers with Mild Airflow Obstruction
Section snippets
Subjects
Fifteen middle-aged male smokers with measurable BHR to inhaled histamine without overt asthmatic features were recruited from those attending a long-term follow-up study of the effects of smoking started in 1974;15 their rate of change in FEV1 over the preceding 12 years was therefore known. At initial recruitment and at subsequent follow-up, all men were encouraged to give up smoking. These men were found to have BHR to inhaled histamine in 1982.16 In that study the majority of smokers,
Double-Blind crossover Trial
Smoking Habits: These were generally similar through the trial (as assessed by stated habits and FECO); one patient unsuccessfully tried to quit smoking for a few days during the trial.
Compliance with Treatment: In the 14 men who completed the trial, canister weights showed a reduction averaging 0.37 g/day with most individuals showing similar values; qualitative measurements of plasma budesonide also confirmed the presence of budesonide in all the men at the end of the appropriate 12-week
DISCUSSION
In the present study we were unable to demonstrate any consistent improvement in baseline lung function, home peak flow, bronchoconstrictor responsiveness, or bronchodilator responsiveness in smokers with mild airflow obstruction following three months of treatment with budesonide. These results contrast with the consistent improvement others have found with similar treatment in patients with asthma,1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 but agree with two other recent studies in smokers with
ACKNOWLEDGMENTS
This work was supported by grants from the Medical Research Council and Chest, Heart and Stroke Association, and some further financial assistance from A.B. Draco. We are grateful to Vic Aber and Robert Robinson for help with the statistical analysis.
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